Citation Nr: 9819496
Decision Date: 06/25/98 Archive Date: 07/06/98
DOCKET NO. 97-16 894 ) DATE
)
)
On appeal from the
Department of Veterans Affairs Regional Office in Winston-
Salem, North Carolina
THE ISSUE
Entitlement to service connection for heart block.
REPRESENTATION
Appellant represented by: North Carolina Division of
Veterans Affairs
ATTORNEY FOR THE BOARD
Margaret Shannon Snoeren, Associate Counsel
INTRODUCTION
The veteran had active duty from May 1979 until March 1980.
This appeal came to the Board of Veteran’s Appeals (Board)
from an April 1996 decision of the Department of Veterans
Affairs Regional Office (RO), Winston-Salem, North Carolina,
which denied the claimed benefits.
CONTENTIONS OF APPELLANT ON APPEAL
It is contended by and on behalf of the veteran that he is
entitled to presumptive service connection for heart block
since it was diagnosed within one year of leaving active
military duty.
DECISION OF THE BOARD
The Board, in accordance with the provisions of 38 U.S.C.A.
§ 7104 (West 1991 & Supp. 1998), has reviewed and considered
all of the evidence and material of record in the veteran’s
claims file. Based on its review of the relevant evidence in
this matter, and for the following reasons and bases, it is
the decision of the Board that
the preponderance of the evidence is against the claim for
service connection for a heart block.
FINDINGS OF FACT
1. Heart block was diagnosed within one year after the
veteran’s separation from service.
2. The heart block was asymptomatic during the first year
following service separation and no medication was
prescribed.
CONCLUSION OF LAW
Heart block was not incurred in or aggravated by active
service, nor may it be presumed to have been incurred
therein. 38 U.S.C.A. §§ 1101, 1112, 1113, 1131, 1137, 5107
(West 1991); 38 C.F.R. §§ 3.307, 3.309 (1997).
REASONS AND BASES FOR FINDINGS AND CONCLUSION
1. Background
When the veteran enlisted in military service in May 1979,
the physical examination did not reveal heart block or any
other heart condition, nor was such a condition noted on the
discharge examination in March 1980 .
In September 1980, the veteran was hospitalized for
evaluation of a seizure disorder and heart block, which had
recently been noted on routine EKG at the time of his
screening for a new drug protocol for asthma. The diagnoses
included Mobitz type 1 and possible type 2 heart block and it
was arranged to have the veteran readmitted for additional
evaluation.
The veteran was again hospitalized in October 1980 for a
cardiac evaluation. The examiner noted a history of a
syncopal episode that was questionably related to the heart
block and palpitations. The examiner concluded that the
syncopal episode was most likely due to a seizure disorder
and was unlikely to be related to Stokes-Adams attack. The
veteran demonstrated Type I second degree heart block with
exercise but was asymptomatic and was discharged with no
cardiac medication.
Private medical records dated in November 1996 reflect random
episodes of atypical chest pain.
A VA cardiac compensation examination was conducted in June
1997. The examiner reviewed the claims file, including the
service medical records, and stated that the type of heart
block shown is at times associated with heart disease and at
times is not. It can occur in normal people and from a
variety of medications. He concluded that it would be
speculative to comment further. The examiner did not express
an opinion as to the etiology of the veteran’s reported chest
pain.
2. Analysis
A claimant for benefits under a law administered by the
Secretary of the United States Department of Veteran Affairs
(VA) shall have the burden of submitting evidence sufficient
to justify a belief by a fair and impartial individual that
the claim is well grounded. The Secretary has the duty to
assist a claimant in developing facts pertinent to the claim
if the claim is determined to be well grounded. 38 U.S.C.A.
§ 5107(a). Thus, the threshold question to be answered is
whether the veteran has presented a well grounded claim; that
is, a claim which is plausible. If he has not presented a
well grounded claim, his appeal must fail, and there is no
duty to assist him further in the development of his claim as
any such additional development would be futile. Murphy v.
Derwinski, 1 Vet.App. 78 (1990). In this case, the veteran’s
claim does meet the test of plausibility and the claim is
considered well-grounded. Further, it appears that the RO
has complied with the duty to assist and there is no other
development required.
The law provides that service connection may be granted for
disability resulting from disease or injury incurred in, or
aggravated by, active military service. 38 U.S.C.A. § 1131
(West 1991).
Further, where a veteran served 90 days or more and heart
disease becomes manifest to a degree of ten percent within
one year from the date of termination of such service, such
disease shall be presumed to have been incurred in service,
even though there is no evidence of such disease during the
period of service. This presumption is rebuttable by
affirmative evidence to the contrary. 38 U.S.C.A. §§ 1101,
1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309. With respect to
the question of whether the disease in question was
manifested to a degree of 10 percent or more, 38 C.F.R.
§ 4.104, Diagnostic Code 7015 provides:
Atrioventricular block:
Incomplete: without syncope but
occasionally
symptomatic………………………………………..10%
Incomplete: asymptomatic, without
syncope or need for medicinal control
after more than 1 year…………….0%
(In effect prior to January 10, 1998.)
Revised rating criteria, in effect since January 10, 1998,
require symptoms of dyspnea, fatigue, angina, dizziness or
syncope during a workload of 7 METs but not greater than
10 METs, or continuous medication or the requirement for a
pacemaker, for a 10 percent rating. Code 7015.
The evidence is clear in this case that heart block was not
shown during service (and the veteran does not contend that
it was), but was noted within the first year after the
veteran’s separation from service. Further, current medical
records also show the presence of the previously noted heart
block.
Accordingly, service connection for heart block may not be
granted on the basis of direct service incurrence, since
heart block was not shown in service and no examiner has
directly attributed the heart block to service.
In light of the diagnosis of heart block during the first
post-service year, however, service connection might be
presumed if the disorder were manifested to a compensable
degree. As indicated above, some sort of symptomatology is
required for a compensable evaluation. However, the medical
evidence does not show that the veteran’s heart block has
ever been symptomatic. The episode of syncope reported in
1980 was attributed to the veteran’s seizure disorder. No
other symptoms have been reported. Therefore, while it
appears that heart block was noted on routine
electrocardiographic studies within one year of service
separation, it was asymptomatic and did not meet the criteria
for a 10 percent rating within that one year period of time.
Therefore, service incurrence cannot be presumed for the
disorder.
In determining whether a claimed benefit is warranted, VA
must determine whether the evidence supports the claim or is
in relative equipoise, with the veteran prevailing in either
event, or whether the preponderance of the evidence is
against the claim, in which case the claim is denied.
38 U.S.C.A. § 5107(a); Gilbert v. Derwinski, 1 Vet. App. 49
(1990). In this case, as discussed above, it is clear that
the preponderance of the evidence is against the veteran’s
claim. Accordingly, the claim for service connection for
heart block must be denied.
ORDER
Service connection for heart block is denied.
C. W. Symanski
Member, Board of Veterans’ Appeals
NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West
1991 & Supp. 1998), a decision of the Board of Veterans’
Appeals granting less than the complete benefit, or benefits,
sought on appeal is appealable to the United States Court of
Veterans Appeals within 120 days from the date of mailing of
notice of the decision, provided that a Notice of
Disagreement concerning an issue which was before the Board
was filed with the agency of original jurisdiction on or
after November 18, 1988. Veterans’ Judicial Review Act,
Pub. L. No. 100-687, § 402, 102 Stat. 4105, 4122 (1988). The
date which appears on the face of this decision constitutes
the date of mailing and the copy of this decision which you
have received is your notice of the action taken on your
appeal by the Board of Veterans’ Appeals.
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